Book reviews

This book seeks to elucidate Thoreau's political thought by a comprehensive and anecdotal tour of his writings. Taylor c1aims that the extant literature on Thoreau either treats his political thought as uninteresting, unsophisticated, and incoherent, or (when treating Thoreau as a political thinker) finds him "too anarchistic or individualistic to be compelling. " This is unfair; the literature is hardly so dismissive. Yet Thoreau was not a systematic political theorist, and Taylor's own conclusions (such as "The fundamental political question for Thoreau is always, therefore, the nature of the moral commitments that bind a community") hardly make him so. Taylor's often rambling search through Thoreau's works for traces of coherence resembles a nature walk more than a treatise, but it serves to focus one underlying issue: Thoreau's conception of "nature" and his use of it as an analytical device.

general table of the whole. By these the reader will be able to judge of the execution, and learn the contents.
The first essay, " on the influence of the mind on the body," should be constantly kept in view, especially by practitioners in the metropolis and in other large towns. Ia more sequestered spots, not only the history, but the moral as well as physical character, and, most of all, the external circumstances of the patient, are pretty generally known.
But, in a larger circle, the patient is often a stranger to the physician, and, perhaps, conceals the most important circumstances in the history of his case?more particularly those corroding, those cankering distresses of the mind, which, in the late unsettled state of the mercantile world, have been the source of so many diseases. All this is extremely well expressed in a chapter, which concludes with some judicious remarks on the probably greater equality of happiness among mankind than the variety of rank would seem to indicate. The next essay, " on the power of volition," contains sentiments so important, so often overlooked, and so well expressed, that we shall select a part of it as a specimen of the manner in which the whole is conducted. It also contains a history which we are glad of this opportunity of recording.
i( We often act on the ill-founded idea that nervous complaints are altogether dependant upon the power of the will; a notion Whichj in paradoxical extravagance, scarcely yields to the doctrine 2*0.213. 3 e of 3Q4.
Critical AnalysisI of a modern, though now obsolete writer, on the Philosophy of Morals, who asserted that uo one need die, if, with a sufficient energy, he determined to live. To command, or to advise a person labouring under nervous depression, to be cheerful and alert, is no less idle and absurd, than it would be to command or advise a person, under the direct and most intense influence of the sun's rays, to shiver with cold; or one who is ' wallowing naked in December's snows/ to perspire from a sensation of excessive heat. The practice of laughing at or scolding a patient of this class, is equally crucl and ineffectual. No one was ever laughed or scolded out of hypochondriasis. It is scarcely likely that we should elevate a person's spirits by insulting his understanding. The malady of the nerves is, in general, of too obstinate a nature to yield to a sarcasm or a sneer.
It would scarcely be more preposterous to think of dissipating a dropsy of the chest, than a distemper of the mind, by the force of ridicule or rebuke. The hypochondriac may feel, indeed, the edge of satire as keenly as he would that of a sword; but, although its point should penetrate his bosom, it would not be likely to let out from it any portion of that noxious matter by which it is so painfully oppressed. The external expression of his disorder may be checked by the coercive influence of shame or fear; but, in doing this, a similar kind of risque is incurred as arises from the repelling of a cutaneous eruption, "which, although it conceal the outward appearance, seldom fails still more firmly to establish the internal strength, to increase the danger, and to protract the continuance of the disease. By indirect and imperceptible means, the attention may, in many instances, be gently and insensibly enticed, but seldom can we with safety attempt to force it from any habitual topic of painful contemplation. In endeavouring to tear the mind from a subject to which it has long and closely attached itself, we are almost sure to occasion an irreparable laceration of its structure. by -which this person assumed the semblance of decease, produced at length a fatal result. Death would be no longer mocked with impunity. The counterfeit corpse, a few hours after its last rerival, relapsed into a state which was capable of no subsequent resuscitation. But the case is so interesting and remarkable, as to deserve our giving it in all the detail with which Dr. Cheyne presents it to his readers. " ' He could die or expire when he pleased, and yet by an effort, or somehow, he could come to life again. He insisted so much upon our seeing the trial mads, that we were at last forced to comply. We all three felt his pulse first; it was distinct, though small and thready, and his heart had its usual beating. He composed himself on his back, and lay in a still posture for some lime; while I held his right hand, Dr. Baynard laid his hand on his heart, and Mr. Skrine held a clear looking-glass to his mouth. 1 found his pulse sink gradually, till at last I could not feel any by the most exact and nice touch. Dr. Baynard could not feel the least motion in the heart, nor Mr. Skrine perceive the least sort of breath on the bright mirror he held to his mouth. Then each of us, by turns, examined his arm, heart, and breath, but could not, by the nicest scrutiny, discover the least symptom of life in him.. We reasoned a long time about this odd appearance as well as wo7 could, and finding he still continued in that condition, we began to conclude that he had indeed carried the experiment too far, and at last we were satisfied he was actually dead, and were just ready to leave him. This continued about half an hour. By nine o'clock in the morning in autumn, as we were going away, we observed some motion about the body, and upon examination found his pulse and the motion of his heart gradually returning : he began to breathe gently and speak softly. We were all astonished to the last degree at this unexpected change, and, after some further conversation with him and with ourselves, went away fully satisfied as to all the particulars of this fact, but not able to form any rational scheme how to account for it.
He afterwards called for his attorney, added a codicil to his will, &c. and calmly and composedly died about five or six o'clock that evening.'* Burton, in his Anatomy of Melancholy, reports cases which were somewhat similar, but by no means equally wonderful with, the preceding. ' Celsus speaks of a priest that could separate himself from his senses when he list, and lie like a dead man, void of life and sense. Qui. quoties volebat, mortno similis jaccbat, auferens se a sensibus. Cardan brags of himself, that he could do as much, and that when he list.'f " Such instances serve to shew that the will can perform wonders in the controul and management of our corporeal frame. If such an extraordinary degree of command be possible, as has been her " * Cheyne's English Malady. H | Burton's Anatomy of Melancholy, vol. i. p. 134. Svo. edit." 3 e 2 yeprcgentcdj 3q5 Critical Analysis.
represented, it is fair to conclude that we may have, in general, a greater power than we are aware of oter the animal and -vital functions. If, by a determination of the mind, it be practicable In some cases to suspend altogether the appcarance of life, it is reasonable to believe, that, by the same means, we may put at ieast a temporary stop to the symptoms of disease. We would not be paradoxical or extravagant enough to assert, that, for a person to be in health, it is sufficient that he wills it; but, without transgressing the moderation of truth, we may venture to give it as our opinion, that a man often indolently bends under the burden of indisposition, which a spirited etiort would, in the first instance, have shaken from his shoulders. ^If, upon the approach of the malady, he had resolutely set his face against it, he would probably have arrested it in its threatened attack. " 1 was once consulted concerning an hypochondriacal lady, who complained principally of an invincible indolence and languor. She seemed almost incapable of voluntary motion. This apparent incapacity had been sanctioned and confirmed by authority as well as indulgence. She had been told by a very complaisant physician that' exertion would be poison to her,' and had too literally reposed under the shelter of that professional opinion. Many, from an anxiety to avoid this falsely imagined poison, reject the tnost effectual antidote to the real miseries of life, as well as to a large proportion of its diseases. To a patient, however, whose malady is lassitude, exertion should be prescribed at first only in ?ery small doses. Such a person would be apt to be exhausted even by an ordinary ta?k of exercise, and might thus be discouraged from further efforts at activity. " In the class of what are called nervous affections, it unfortunately happens that the very essence of the disease often consists in a debility of the resolution; that the ailment of body arises from an impotency of spirit, a palsy of the power of resistance. A malady, occasioned by the weakness of the mind, is not likely to be cured by its energy. A tendency to sickness of the stomach may often be overcome by striving against it; but a squeamish disgust of life cannot, in the same degree, be counteracted by a similar kind of exertion. It is not uncommon to say to a drooping or desponding valetudinarian, ' only exert yourself, and you -will get the better of your complaint;' whereas, in many instances of this kind, it might as well be said to au invalid confined to his jbed by a paralysis of his limbs, only run or walk and you will be well. People, in general, are apt to think that a man, under the ?weight of constitutional or habitual melancholy, may keep up his spirits as a little miss can hold up her head, upon merely being bid to do so. " It is often as impossible for an hypochondriac, by any voluntary effort, to get the better of his complaint, as for a man of ordinary stature to gain an ascendancy, when struggling under the compression of a giant." The Dr. Reid on Hypochondriacal and other Affections. 397 The third essay, on " the fear of death," contains more novelty than we could have expected on such a subject, and even some directions for the relief of this form of melancholy, which, if not new, have not occurred to us before. The fourth essay is " on pride," and, like most of the others, partly moral, though all directed to physical objects.
The fifth is " on remorse," which may be considered, for the most part, only one form of hypochondriasis, unfortunately affecting those principally who have the least reason to reproach themselves.
The succeeding one, " on solitude," shews, in a very pointed manner, the necessity of cultivating social and industrious habits. The seventh essay, " on excessive study, or mental applU cation," we deem peculiarly important, for, whatever may be thought of the frivolity of the age, it is certain that there is more close application than at any former period of our history. The extraordinary talents required at the bar, in the pulpit, and, most of all, in the senate, are a constant stimulus to every enterprizing youth, and, unfortunately, its effect is greatly increased by the ambition of families of every description above those consigned to mere mechanical employments. The consequence of this is often an inattention to the moral character, and still more to the health, of the rising generation. This chapter is enriched with the case of a studious youth, who, from the apprehension of losing some academic honours, the acquisition of which he had anticipated, became, for a time, nearly insane. He, however, recovered. We could relate a less fortunate instance, and one which has made us doubt the real value of academical prizes, unless confined to poetry. If one person is elated, how many are distressed ; and we may ask further, is not the acquisition of an expected honour frequently the harbinger ot future inattention, partly from the intensity of previous study, and partly from a supposed superiority, which requires no longer any application whatever. Meanwhile the less successful candidates are dissatisfied either "with themselves or with tho*e who have the distribution of the prizes; and sources of jealousy, and even hatred, invade a sanctuary which should be unalloyed by such dangerous intruders. The author's instructions at the conclusion of this chapter cannot be expected to oe altogether new: they are, however, very judiciously selected. In justice to our English universities, we ought to remark, tiiat the examinations are now more judiciously arranged, so ttiat there is less danger from honours which are open to all; but the prizes are still often attended with ill consequences.
Essay 393 Critical Analysis. Essay VIII. is entitled?" Vicissitude a cause and characteristic symptom of intellectual malady." If there is any chapter to which we should object it is to this ; first, which may seem odd, because it is too short, that is, we conceive it might have been incorporated with some other; but most because it abounds too much with allusions not strictly medical. By this time our readers must have perceived in our remarks on many occasions what, perhaps, some may call a prudery in whatever relates to language. We are ready to acknowledge that this fastidiousness ill accords with some of the figures we meet with in the notes, as well as in the text, at the beginning of this chapter. We are ready to impute this to a richness of imagery, which, if we judge rightly, the author is incapable at all times of concealing. It becomes us, at however, to acknowledge that it has its attendant advantages of constantly keeping the attention alive, by wellarranged periods and well-selected phrases; of which the concluding part of this very chapter furnishes a striking example. It may be added that this is the most important part, as it contains the mode of treatment.
The chapter on the " want of sleep5' follows. On this occasion we shall offer our own remedy, in addition to bathing, which is proposed by our author; and the value of which we are ready to admit. Where the mind is so engaged on a single object as to prevent sleep, we have found a novel, not too interesting, but sufficient to disengage the patient from his former train of thoughts, a most certain remedy. It is not merely the interest he takes in the history, but the world of fiction into which he is now introduced, will often disengage him from the objects around him, or make him think less of them, from a momentary absence, or sometimes from the superior grandeur of the characters with which he now seems conversing. Nor ought we to forget the celebrated remedy, the pillow of hops, which first closed the watchful eyes of our unfortunate monarch! The following chapter, on " intemperance," is full of good things, and the term very properly extended beyond the use of wine or ardent spirits. Opium and its effects meet with due consideration, which is the more important, as it is very generally admitted that recourse to this dangerous drug has increased in proportion as indulgence in wine has diminished among us. This chapter includes also the sudden acquisition of wealth among the stimuli, equally injurious with the former.
The author asserts, with much truth, that tfiere is little danger to the mind from a depression of external Dr. Reid on Hypochondriacal and other Affections. 399 ternal circumstances, compared to what often arises from sudden elevation.
It is next shewn that the extreme abstinence to which some hypochondriacs confine themselves is often not less injurious to the health than the contrary indulgence. A very ingenious chapter follows on the organs of sense, as connected in their imperfection, or the injuries they receive with the state of the mind. This concludes with a slight reference to a question, often agitated, whether the loss of sight or hearing, is the most to be regretted. The remarks here refer principally to the loss of sight.
" One case (says Dr. R.) of melancholy I well recollect, which was remarkable from the patient not having been afflicted by it until after the deprivation of his sight. Reflection upon that loss could not fail, for a time, to have been itself a source of uneasy feelings, but the continuance and gradual aggravation of his depression may be better accounted for, by his not being longer able, in consequence of this loss, to pursue his usual active employment, by its withdrawing from him the natural and exhilarating stimulus of light, and by its precluding altogether the possibility of that amusement and diversion of mind which, in general, is so constantly derived from the contemplation of external objects; to which may be added, that by confining the sensibility within a gusted with the world, retired, and called lip to his imagination an ideal set of beings as perfect as he conceived men ought to be, and as he foolishly thought himself. To do this, he was obliged to leave society, and soon found the ?want of it by his perpetual visits to the metropolis. The blind man, on the contrary, has all the blessings of social intercourse, and enjoys his ideal world without the necessity of retiring from society. Having nothing to distract his attention when not engaged in conversation, having his own choice in the society and in the books he wishes to hear read to him, Ave find him constantly with a smile on his countenance, when taking what may be called his solitary "walks. If his last conversation was agreeable, he dwells on it at his leisure, without the distraction of his mind by external objects ; or, if other recollections are more agreeable, devotes himself to them, or to fond anticipations, often more pleasing than the object itself when acquired. We have dwelt so long on this interesting performance, that our limits will not permit more than a general recapitulation of the remainder.
The rest of the essays are entitled, " mental derangement not indicative of constitutional vigour of body or mind"? " physical malady the occasion of mental disorder"?a short chapter " on the atmosphere of London"?another on "dyspeptic and hepatic diseases"?a very long and interesting one on " palsy, idiotcy, and convulsions." On the next, concerning the " hereditary nature of madness," we feel constrained to regret that the peculiar force of the author's style has, in our opinion, betrayed him into something like an anathematous mode of expression, which, if not absolutely necessary, cannot be excused. We shall give his words, and then offer our objection. " Nothing (says he) can be more obvious than that one who is aware of a dccicled bias in his own person towards mental derangement, ought to shun the chance of extending and of perpetuating, without any assignable limit, the ravages of so dreadful a calamity.
No rites, however holy, can, under such circumstances, consecrate the conjugal union. In a case like this, marriage itself is a transgression of morality. A man who is so situated, in incurring the risk of becoming a parent, involves himself in a crime which may not improbably project its lengthened shadow, a shadow, too, which widens in proportion as it advances, over the intellect and the happiness of an indefinite succession of beings. " The ruffian who fires at the intended object of his plunder; takes way the life of him only at whom his aim is levelled. The bullet which penetrates the heart of the unfortunate victim, does, in general, no farther mischief. But he who inllicts upon a single individual Dr. Reid on Hypochondriacal and other Affections. 401 individual the worse than deadly wound of insanity, knows not the numbers to which its venom may be communicated : he poisons ^ public stream out of which multitudes may drink : he is the enemy, not of one man, but of mankind.*' Let us reflect that no reserve of this kind is made "when the Fiat or blesiing was pronounced to our first parents, and in them to us all-?" be fruitful and multiply." But we have heard it called unfair to quote Scripture in physiological arguments; and, perhaps, there may be objections to it, as it ' always leads to verbal controversy. We only wish then to reflect how few there are who can throw the first stone.
In what family may we not trace instances of insanity. But this is only a small objection to such a theory. Whence, we would ask, originated this hereditary disposition to madness.
Unless we can trace it to Noah or his children, it must commence in the offspring of a pair free from the malady; and this would at once lead to an extinction of the race, if marriage were deemed improper, lest the issue should be mad. Let us consider further, how nearly we all approach, at certain intervals, to madness, and" even accuse ourselves of acting under such an impression. Still more to what but an enthusiasm bordering on madness, and, for the most part, connected with such a family propensity, do we owe most of the great and good actions which become the aggrandisement of a family, the boast of a nation, and often the melioration of the whole human race. We should not have dwelt so long on this head, had we not a practical knowledge of the moral disadvantages attending the prevalence of Dr. Reid's opinion. On the profligate and unprincipled it produces no effect. On the amiable and good, who, of all others, are the fittest to become parents, the interdiction is often viewed in a moral light, and probably the world, by that means, is deprived of individuals who might have proved its brightest ornaments.?We have thrown out these hints with a sincere wish that the author, in a " more systematic and complete" work, which we still hope to see, will consider this question more maturely, and with less regard to his early impressions. The chapter on " old age" abounds in useful reflections. The succeeding one, on " Lunatic asylums," is a subject which has lately been so closely canvassed that we shall not add more to it. Some judicious observations follow on ** counteracting-the first tendency to madness," and on "lucid intervals." In the following chapter, on " bleeding," we think the author, as well as Dr. Heberden, evinces more -caution than is necessary, and that the error is more fre-* 3 F tjuently 402 Critical Analysis, quently on the side different from that marked by him and liis venerable predecessor; but this is mere matter of opinion.
The remaining chapters, on ?C pharmacy"?011 " bodily exercise"?on " real as a remedy for imaginary evils"?on 4< occupation,"?contain useful remarks; but we cannot venture to extend our own or our extracts any further. It cannot be necessary to give any general opinion of the work, as that will be readily collected from the perusal of what we have offered.
A Compendium of Medical Practice, illustrated by interesting and instructive Cases and by Practical, Pathological, and Physiological Observations. By James Bedingfield, Surgeon, late Apothecary to the Bristol Infirmary.
?Highley and Son. pp. 30Q. This is a very useful book, but the title, instead of being, to speak technically, a taking title, is a real injury to it. Had it been called A Selection of Cases which occurred at the Bristol Infirmary, with the Examinations after Death, and printed on a somewhat less expensive plan, it must have found its way to most medical libraries; for we will venture to say, that few books contain more practical information, derived from the best sources. This information in the greater number of cases serves to confirm what is now pretty generally understood, namely, that in all acute diseases the practitioner is constantly to keep in view the preservation of all the organs from the dangers immediate and remote of high inflammation. Many of the pathological remarks might have been spared, but on these occasions we are never fastidious. If we were, might Ave not reject Morgagni himself, and still more Bonetus, who reasons gi-avely concerning a cancerous liver?
We shall offer a few of Mr. Bedingfield's cases as the best mode of giving the reader a correct knowledge of the whole; and, having in our last Number a very long paper on Tracheitis, we cannot do better than transcribe the examinations more immediately connected with that disease. " Pharyngis Ulceratio.?Margaret Semay, aged 30 years, was admitted on the l4th of December, 1814, with the usual symptoms of pneumonia. For their relief she was bled, antimonial medicines prescribed, and a strict antiphlogistic regimen enjoined.
<4 Under this treatment, persisted in for fourteen days, she appeared to be nearly recovered; when she began to complain of a disagreeable sensation about the throat, attended with a disposition to cough, and a frequent discharge of frothy mucus. These symptoms gradually became more urgent and distressing; a disagreeable hoarseness succeeded, which sometimes was so great as to prevent what Mr. Bedingfield's Compendium of Practice. 403 what she said from being understood; at other times she could only whisper faintly and indistinctly. " Difficulty in deglutition and respiration was next experienced ; deglutition occasioned much pain ; the inhalation and expulsion of the air, produced a peculiar and disagreeable sound. A sound somewhat similar may be feigned by drawing air quickly and for* cibly down the trachea, at the same time contracting the glottisj and making an effort to form the guttural sound ur-r-rh-r, Instead of this noise, occasionally an unpleasant whistling prevailed.
(i These symptoms evidently pointed out a diminution, from some cause, in the capacity of the glottis or trachea; while the in? cessant cough, copious expectoration of frothy mucus, and pain felt upon handling or pressing upon the sides of the thyroid cartilage, seemed to indicate that ulceration existed upon some portioa of the membrane lining the larynx. " Upon inspection of the posterior parts of the fauces and pharynx, no trace of disease could be discovered; but the difficulty and paiu experienced in swallowing, rendered it probable that some morbid change of structure existed out of sight. t{ The patient remained in this state for twelve weeks, -when the powers of life rapidly declined. Her pulse became almost imperceptible; respiration laborious; deglutition nearly stopped. In this state she continued four days, when she suddenly threw up a large quantity of blood from the lungs, which threatened instant suffocation. She expired within a few hours after this occurrence. " The appearances which the parts exhibited upon dissection, afforded a satisfactory elucidation of the symptoms which existed during the life of the patient. The trachea and bronchiaj were particularly narrow.
" Just below the arytajnoid cartilages, a considerable degree of inflammation had existed. Marks of increased vascularity were very apparent; a redness extended itself for the distance of an inch and an half along the posterior part of the trachea. I shall have occasion again to notice this circumstance, when the disease whicfi existed in the pharynx is described.
<c At the anterior part of the pharynx, just below the rima gloftidis, a tumor in shape and size resembling a filbert, was situated. Its external surface, or that part looking towards the back of the pharynx was smooth, and it had the appearance of an absorbent gland; that portion of it (its basis) which was opposed to the anterior part of the pharynx was in a state of ulceration. By its pressure it had likewise produced an ulceration of the membrane of the pharynx and the adjacent mnsclcs.
<? This ulceration extended for a considerable way downwards, and by it an excavation had been effected, which, had the patient lived a short time longer, would have formed a communication between the pharynx, larynx, and superior part of the trachea; the membrane spread upon thoso parts forming the only barrier between thera. This is the spot to which I alluded as being in an in. ii The sliyht partition which existed between the pharynx and lannx, and the superior parts of the trachea and oesophagus, could not be discovered, until a considerable quantity of curd-like scrofulous matter had been dislodged from the excavation. " Several scrofulous tumours, about the size of large glandular Pacchionte were met with upon the inner surface of the oesophagus. No disease was found in the lungs or abdominal viscera. " Laryngis Ulceratio.?This disease is of more frequent occurrence than is generally suspected. It is often mistaken for phthisis pulmonalis; but the peculiar hoarseness and the difficulty of respiration with which it is attended, together with an almost total excmption from hectic paroxysms, are circumstances which will enable us to disiinguish them from each other. Its precise nature will be best elucidated by a narration of one or two cases. ei William Birch, aged thirty-nine years, was severaltimes admitted into the infirmary in the course of three years, labouring under symptoms of pneumonia. These symptoms were uniformly relieved by venesection, blisters upon the chest, and low diet; he complained however of a ' tickling sensation about the upper part t)f the throat with a constant desire to cough,' and his voice gradually underwent considerable alteration. At first it was only thick, but it became by degrees exceedingly hoarse and disagree, able. rot examined ; from having however inspected several similar cases in which no disease of those organs existed, I am inclined to believe that in this case they were but little, if at all affected. 44 Laryngis et Trachtce Ulceratio.?-Sarah Hopkins, aged nineteen years, was admitted on the 2d of June, 1814, affected with difficult respiration accompanied by a peculiar noise in the trachea somewhat resembling croup, a cough, and a soreness of the throat, Upon inspection of the fauces the uvula was observed to be elon. gated and the tonsils enlarged. She exhibited no marks of consti.
tutional disease nor of debility; her pulse was perfectly natural, and she was perfectly free from pain in the chest. According to her own account, she had been in the state above described three months.
"Twelve ounces of blood were taken from the arm; a blister applied to the chest; a saline antimonial mixture taken every six hours; and a lohoc whenever the cough was troublesome.
44 June 4th. The same difficulty of respiration; bowels con. lined. A cathartic powder was ordered to be taken immediately ; and twenty drops of tincture of opium mixed with forty drops of tartarized antimonial wine at bed-time. 44 Early in the morning of the 5th, she died suddenly. Her breathing had become more laborious the preceding evening. " The rima glottidis was very much contractcd and the epiglottis abraded upon its sides and concave surface. 44 An ulcerated surface commencing at the superior and posterior part of the larynx extended downwards to a small distance below the ventricles of Galen.
" The trachea was filled with purulent matter. Upon this being sponged away, an extensive and deep ulceration was discovered upon its posterior part, about half an inch below the inferior aperture of the larynx. About a quarter of an inch below this, upon the anterior part of the membrane, another ulcer was situated. This ulcer spread in a circular direction and nearly em.
braced the whole circumference of the trachea for the space of the third of an inch. In short the whole surface of the trachea was more or less destroyed by the disease, to within about half an inch of its division into the bronchia. Upon this small portion there were slight traces of inflammation, and its follicular structure was very apparent. 44 The membrane lining the bronchia? was highly vascular, but no disease existed in the lungs, heart, or abdominal viscera. 44 Every case of ulcerated pharynx, larynx, and trachea, which has fallen under my observation has terminated fatally, and I feel kiyself incapable of suggesting any perfectly satisfactory or successful mode of treatment; I suspect however that much time is lost in having recourse to constitutional remedies, instead of regarding it as a local affection.
? 44 The disease is extremely insidious in its approaches, and pro?
gress, and will often commit extensive and irremediable ravages before its existence or nature can be ascertained." A chap-406 Critical Analysis, A chapter follows on Hannoptoe containing some pointed, and in some respects judicious, remarks on the frequent and free use of digitalis. We shall occasionally refer to this -work in common with other collections. Its value stands much higher than a mere sepulchretum because most of the cases were Jong enough in the hospital to afford a thorough knowledge of the symptoms and of their correspondence with the subsequent appearances.
The following 'paper on a disease so frequently unmanageable does credit to the author's candour. o 44 Epilepsia.?Most sincerely do I lament my inability to furnish a successful method of treating this formidable malady, but I have known every measure which consummate ability and ingenuity could devise, rendered perfectly abortive when it has been of long duration. 44 By far the greater number of epileptic eases arise from causes which we cannot ascertain, or which, if ascertained, perhaps, we do not possess the power to remedy, 44 The treatment I have seen upon the whole the most efficacious was the following. 44 The force of the arterial system was diminished by drawing blood from the arm in small quantities, as frequently as circumstances indicated ; an active purgative was given once or twice a week, and on the intermediate days, the oxid of zinc in sufficient doses to excite nausea. 44 To adults were usually prescribed five grains three or four times a day, gradually increasing the quantity to a scruple. It will seldom be found necessary to give a larger dose than this, although a larger may be taken without injury. With children it will be advisable to begin with one or two grains. 44 By persisting in these measures for a length of time, in several cases of extreme obstinacy and violence, the disease was suspended ; upon laying them aside it returned, and generally terminated in fatuity or death.
441 have given the spirit of turpentine in large as well as in small doses, but no decided benefit accrued from its exhibition.
4f In incipient cases, where the disease depended upon the retention, suppression, or imperfect flow of the catamenial discharge, venesection employed monthly, with active purgatives and electric shocks applied to the pubic and lumbar regions, has been decidedly useful. Bleeding, instead of diminishing the interval between the paroxysms has always appeared to me to increase it.* " When 44 * This observation is, I believe, in opposition to generally received opinion. 44 A few months ago, I bled a patient while labouring under an epileptic paroxysm with manifest advantage. In this case the heart and carotid arteries throbbed with great violence, apoplectic 1 stertor Scarpa on the Cutting Gorget. 407 i( When cpileptic fits depend upon the presence of worms in the intestines, means must be resorted to for their speedy expulsion. " Sometimes epileptic fits arc cxcited by the pressure of an extraneous body upon the brain, as a spiculum of bone. If we should be fortunate enough to discover its situation, we must remove it with a trephine. A slight depression upon the surface of the cranium will sometimes lead to a detection of the injured part. u The brains of epileptic patients will be generally found to present the same diseased appearances as are met with in persons who die of serous apoplexy." He further remarks, that he has sometimes seen the superior part of the cerebellum with an appearance as if pus were deposited beneath the pia mater. A Memoir on the Cutting Gorget of Hawkins, (containing an Account of an Improvement in that Instrument, and Bernards on the Lateral Operation for the Stone.) By Antonio Scarpa, Member of the National Institute in Italy, &c. &c. Translated by James Briggs, Surgeon to the Public Dispensary. London. 8vo. pp. 2Q.
By an advertisement prefixed, we learn that the Translator was favoured by the Author with this paper, extracted from the Transactions of the National Institute of Italy, accompanied with a request that Mr. B. would translate it. We can only express our gratitude to both.
Whoever reflects on the operative part of surgery must, we conceive, be convinced that, to a " good workman," the proper cutting instrument is the scalpel. With this, Mr. Hunter undertook to perform every operation requiring incision, and with this he operated successfully in the stone. But, as this operation must sometimes be performed by men less conscious of their anatomical knowledge, there is mucli propriety in every assistance that can safely be afforded them.
The professor of course adverts to the imperfections of former instruments. As the chief objection is to their complexity and consequent uncertaifity, we shall only transcribe liis remarks on Cheselden. stertor had commenced, and I am strongly inclined to suspect, that, had not thirty ounces of blood been speedily drawn away, eliusion upon the brain would have taken place. For several days after the attack the mental faculties were much impaired, and it was apprehended that the case would terminate in complete fatuity; the powers of the mind however gradually returned, and the patient is aow in a fair way of recovery. January 1S16. 408 -Critical Analysis. " Cheseldefi, to whom alone belongs the merit of having efnricheil surgery with the important invention of the great lateral apparatus, in performing this operation, made use of a knife with a convex cutting edge, four lines broad, fixed upon a long handle. With this very simple instrument^ he divided the prostate gland laterally through its whole length, to the depth of four or five lines; after which, by means of a slow and gradually increased dilatation of the neck of the urethra* and orifice of the bladder, he extracted large calculi without any ill consequences ensuing to his patient. It is not however so easy a matter as an inexperienced operator might perhaps imagine, to pass a knife, within the neck of the urethra, beyond the orifice of the bladder, so that in its course it may not deviate, sometimes considerably, from its lateral direction, and divide "the prostate gland to a proper depth, especially at the base, which surrounds the orifice of the bladder; for the point of the knife is easily stopped in the groove of the staff, and either from the strong resistance which the firm substance of the prostate gland generally opposes to the gorget, so as to press it on the opposite side, or from the gland receding from the instrument, the surgeon is lead to suppose that he has laid this glandular body open to a sufficient depth; when in reality he has only divided the apex,, and a very small part of its base. 44 To render the execution of the lateral operation easier to surgeons of less experience than Cheselden^ was the laudable motiv? which induced Hawkins to propose his gorget. He thought that two great advantages would be gained by the use of this instrument ; one, for instance, of executing invariably the lateral inei* sion of Cheselden, the other, of constantly guarding the patient through the whole course of the operation from injury of the rectum and of the arteriapiidica profunda. Its utility as to the latter of these objects cannot be disputed, as it is evident that the convexity of the director of the instrument defends the rectum from injury, and that its cutting edge not being inclined horizontally towards the tuberosity and ramus of the ischium, but turned upwards in the direction of the longitudinal axis of the neck of the urethra, cannot wound the pudic artery. But, with respect to tha first advantage, or that of executing precisely the lateral incision of Cheselden, it must be admitted, that it does not completely fulfil the intention which he proposed, not only on account of the cutting edge of his instrument not being sufficiently raised above the level of the staff to penetrate sufficiently the substance of the prostate gland, and consequently divide it to a proper depth, but because being too much turned upwards, at that part of it which is to lay open the base of the gland, it does not divide it laterally, but rather at its upper part, towards the summit of the ramus of theischium and the arch of the pubis; an opening, of all others, in * It may be right to remark, that Professor Scarpa objects to the term cervix, or neck of the bladder; and, in our opinion, with muQh propriety.?Edit-. tHg Scarpa on the Cutting Gorget.

409
"the perinzeum, the most confined, and presenting the greatest impediment to the passage of the stone from the bladder. The breadth of the point of the director is, besides, so disproportionate to the diameter of the membranous part of the urethra, that from the great resistance with which it meets, the instrument may easily slip from the groove of the staff, and pass between the bladder and rectum,?a serious accident which has very often happened even in the hands of experienced surgeons." The description of the instrument would be scarcely intelligible without the drawing, a copy of which we do not conceive ourselves authorised to give. The mode of using it will sufficiently explain the advantage the author proposes, and has himself experienced.
The method of operating with this instrument is as follows: having introduced the staff into the bladder, the curvature of which corresponds exactly to that of the axis of the neck of the urethra and prostate gland, and the extremity of which is rather longer than that of the ordinary staff, so as to penetrate the bladder to the extent of an inch and a half, and the external incision, and opening into the membranous part of the urethra, being made in the usual manner, avoiding the bulb, the surgeon with his left hand should hold the staff firmly against the arch of the pubis, in a line perpendicular to the body of the patient; then taking hold of the gorget with his right hand, and inserting the beak in the groove of tha staff, so that the convexity of the director may be directly placed over the rectum, should run the gorget on, in a line as nearly parallel as possible to the horizontal extremity of the staff situate in the bladder, not stopping until he feel that the beak of the instrument has reached the closed extremity of the groove of the staff.
?After having removed the staff from the bladder and urethra, and introduced the forceps upon the groove of the gorget, the latter is to be gently withdrawn upon them, in the direction in which it had been introduced. Lastly, the position of the stone being discovered, by means of the forceps, the blades are to be gently opened, and the neck of the urethra and orifice of the bladder, so far gradually dilated by them, that the operator may be able to take hold of it easily, and extract it, without bruising or lacerating the parts through which it is to pass. iC It is a certain fact, which I have ascertained by repeated ob-. servations and measurements, taken from the dead subject in the adult, that a line inclined to the axis of the neck of the urethra and prostate gland, at an angle of 6^?, passes laterally through the base of the gland, at the part most convenient of all others for tha extraction of the stone in the perinceum, this being neither too near the arch of the pubis, nor the inferior and posterior surface of the gland.* And, as the cutting edge of the gorget is inclined to the longitudinal 44 * The prostate gland is shorter on its anterior than posterior surface; and the cervix of the urethra docs not puss precisely NO. 21?. 3G through 410 Critical Analysis.
longitudinal axis of the director, precisely at the same angle, whes the instrument is held in the direction of the natural axis of the neck of the urethra and prostate gland, it follows, from mechanical necessity, that in pressing it into the bladder in a line as nearly parallel as possible to the horizontal groove of the stall', the whole of the gland, with the orifice of the bladder, must be cut through at this precise point.* " The statf being held firmly against the arch of the pubis, in a line perpendicular to the body of the patient, so that the convex part of the director may be placed towards the rectum, and take the exact course of the axis of the neck of the urethra and prostate gland, is an invariable guide by which the cutting edge at this determined angle must of necessity divide the gland laterally at the part most advantageous for the removal of the calculus. This rule is the more easily to be determined, and more securely observed, as the staff" lodges itself, as it were, under the arch of the pubis ; and as this, of all the positions which can be given to it, is the firmest and the most commodious to the surgeon, during the operation." We have not yet heard that this instrument has been tried in London ; but, that it will be, cannot be questioned, from thp high reputation of the inventor and the liberality of the surgeons in the metropolis. As soon as we are acquainted ?with the result, we shall not fail to inform our readers. This pappr is supposed to be the production of Prof. Kurt Sprengel, of Halle. That it is a German or Flemish production, can admit of no question. through the centre of it, but through that poriion of it which is nearest the arch of the pubis. On account of the greater shortness, therefore, of the cervix of the urethra, and smaller bulk of the gland, the nearest way from the membranous part of the urethra to the cavity of the bladder, would be through the anterior part of it; but as the inpision made in the smaller portion of it would fall immediately under t|ic arch of the pubis, which would present a great obstacle to the passage of the stone, the lateral incision, though carricd through the longest and thickest part of it, must always be preferable to a division of it anteriorly. " * In the construction of the instrument, therefore, great skill and accuracy are requisite on the part of the artist.
Edinburgh Mtdical and Surgical Journal. 411 It commences with the history and literature of medicine.
Here, as might be expected, we meet with German labours, German commentators, and German translators. Of all that is English, we have only Dr. Falconer's opinion concerning the Morbus Cardiacus of the ancients, published in the Memoirs of the London Medical Society, a work certainly full of learning, hut, as we remarked when it first appeared; far from satisfactory in its conclusions.' The most important of all the works mentioned in this division of the paper is, in. our opinion, Gainer's Itmerarium sudoris Anglici ex actis tlesignatum. We are surprised, considering how much our island and our countrymen in every part of the world were interested in this question, that the work was never reprinted in England, nor found its way into any of our periodical journals. This is the more remarkable, as it was Avritten in Latin, a language well understood by the reading part of the profession.
A general view follows of all the periodical publications on medicine in Europe and America. Here it is pleasin g to mark the candour of a foreigner. Whilst handsome compliments are paid to the quarterly production of Edinburgh, and the monthly journals of London, those cold-blooded, trimestral and annual attempts at stifling genius which were extinguished, not for want of talent in the performers, but from the disgust with which they inspired every honest breast, are altogether unnoticed.
The anatomical division follows, in which we are pleased to find that Great Britain is treated with the same courtesy. Whilst manuals and vade-mecums are enumerated without ?end in Germany, those disgraceful compilations which have issued from the English press, suited only to assist the memory of the student immediately before examination, or to make him fancy he has a complete practice of medicine in bis waistcoat-pocket, are left unnoticed. Some others, which are passed over, might have been mentioned > but we ought to he thankful that, whilst Sir E. Home's account of the new discovered lobe in the prostate gland, as well as his hints concerning secretion, are passed over, his lectures at the College are respectably introduced, in the division of comparative anatomy, and even in company with the justly-celebrated Cuvier.
Chemistry is almost confined to animal substances, and, with much propriety, allowed to take her place, not as the mistress, but the handmaid, of physics. Like other officious inleniunai, it is difficult to say whether she has done more good or harm. The present, however, seems the time when siie is likely.,by reforming her own errors, to instruct us how -3g 2 little 412 Critical Analysis; little assistance we can derive from her. Let not the reader suppose that we have any wish to undervalue the labours of Woolaston, Davy, Berzelius, or Bostock. To the first we owe some important analyses of diseased productions; the second is not to blame if his brilliant discoveries have led inferior talents astray; and the two latter have executed whatever they undertook with so much fidelity, as to furnish us with satisfactory data.
The microscopical observations, which, in our opinion, 4 J J same subject, which never can interest a native, still less, we should think, a student, in the country that gave birth to a Bacon, aHervey, a Sydenham, or a J. Hunter. <? Among the physiological writers of France during this period, K. L. Dumas, P. J. Barthez, and A. Richcrand, are the most important. The first, by distinguishing the physical, organic, and vital powers, and by adopting Bichat's ideas of the differences of the various systems, introduced better principles, and explained the nature of the secretions better than had been done before him. But Dumas was indebted for his arrangement, and his idea of a power of fixed position, to that excellent master of his art, Barthez, of whose work a new edition was published. A peculiar combination of chemical with dynamic principles, resting upon very multifarious hidden powers, occurs in Richeraud's fourth edition.
The Italians can boast of having produced three of the principal physiological works of this period, by Jac. Tommasini, ono of the most acute and best informed authors, by Jos. Jacopi, and by Stef. Gallini. " We have become acquainted with two British publications belonging to this department; one popular, the other idealistic." Few of our readers are ignorant of Richerand. Bichat js not without merit, which is, however, obscured by the great pains he takes to obscure our Hunter. Had he contented himself to pursue, continue, and enlarge, the discoveries of such a predecessor, we should have learned something more than we now know, and all Europe would have been enlightened. On this we have said enough in our remarks 011 Bichat's work. We are not disposed to quarrel with our author for the little notice he takes of English physiologists since the days of Hunter. Several paragraphs follow on the structure and physiology of the brain and nerves. On this subject, we wait for a fair opportunity of presenting our readers with the state of science and conjecture up to the present time. At present we shall only remark, that the Professor gives Gall the credit of reviving and improving a correct mode of examining the brain. On the subject of craneology, bis remarks are, in our opinion, too general. This is, however, a mere opinion; and, for the reason above mentioned, we shall abstain, at present, from any further notice.
We shall observe the same silence on the probably for ever incomprehensible subject of muscular motion. The subject of respiration is compressed with equal accuracy and judgment.
" No function (says the author) of the body was more accurately investigated in all points of view, and in all its relations, than respiration. Sommerring and liqissdscn examined at the same tirae 4 it Critical Analysis time the lungs, their cells, and the termination of the vessels, ant? taught that the par vagutn, and not the intercostal nerve, supplies the bronchial vessels. For this last reason, and from experiments, M. A. Caldani concluded respiration to be voluntary. Dupuytren's experiments established the influence which the par vagum has upon the functions of the lungs, and upon the change of the colour of the blood. Even by alternate pressure upon the nerves, the red blood was darkened.
Hence he concluded, that such animals die in a state of asphyxia; he also found Bichat's observations confirmed, that, after the division of the pulmonary nerve, life continues for a time. Ducrotay de Blainville extended these experiments to several classes of animals, and found, that in birds, after the division of both nerves, life not only continues for six or seven days, but that likewise the chemical properties of the blood suffer little change. These experiments were rectified by Dumas: he shewed that the arterial blood became black in consequence of* the disturbance of the functions of the lungs, causcd by the paia from dividing the nerves. Similar conclusions were drawn froui the experiments of Provencal, and of A. G. F. Einert; from the latter of which it appeared, that the change of venous into arterial blood continues to take place even after the division, provided the air still penetrate into the lungs. By the experiments of C. Gallois, already mentioned, it was finally proved, that the impulse to the., motion of the organs of respiration likewise proceed from tho spinal marrow, and that in animals, after their heads were cut off, respiration could be supplied by the blowing in of air. P. II, Nysten shewed, by experiments, to what changes the chemical properties of the expired air are subject in diseases. " Comparisons.with the phenomena in other classes of animals arc no where more necessary than for the explanation of respiration. Hence the observations and experiments of F. L. A. W.Sorg, and of C. L. Nitoche, were very valuable, as explaining the difference of the changes which respiration produces in the lower classes of animals; hence likewise F. v. P. Gruithuisen, in his above-mentioned Organozoonomy, and L. Oken, in his Philosophy of Nature, justly believed direct respiration, without circulation, to consist in the gasses passing immediately into the body, but that, in the higher classes of animals, and in man in particular, the changes of the fluids in respiration are produced more by an internal activity. Hence it is necessary to limit the earlier assertion of Humphrey Davy and J. Bostock, that, even in man, oxygen,and even nitrogen, are really consumed in respiration; and that the former is not employed only for the formation of carbonic acid gas. This opinion was, indeed, totally refuted by W. Allen and W. II. Pepys, who proved, that, in man, the blood never absorbs any nitrogen in respiration, and that the whole of the oxygen is employed for the formation of carbonic acid. Humboldt, Provencal, and Configliacchi, on the contrary, pointed out the immediate passage of the gases in fishes and the lower animals, and their deposition in the Swimming-bladder of the former," Candour Edinburgh Medical and Surgical Journal. 415 Candour obliges us to make this long transcript, because some of the experiments have been repeated in London, without any acknowledgment of what was done abroad. Ill return, however, we are not disposed to excuse the mention, in a previous passage, of C. Galiois' experiments concerning the continuance of respiration in decapitated animals, which have been anticipated by Mr. Brodie and even by John Hunter. On the conclusion drawn by the French philosopher, we have lately had occasion to make some remarks when speaking of the productions of an English physician. Hereafter the subject will come before us in a more insulated form.
The remains of the paper, as far as we are hitherto fa- Regiment. This paper does great credit to the courage, research, and candour of the author. He selected the discharge from three different patients, at different stages of the disease, and applied them to his own eye, but found no inconvenience.

41"?
In the spring .and summer months of the year 1813, ophthalmia-?Xtensively prevailed in the British garrison of Palermo, Many ?of the inhabitants were likewise attacked with it." It is also well known that ophthalmia has been epidemic in regiments in England. From all which we are inclined to believe that ophthalmia is oftentimes only one form of the effect produced b}'crowding diseased individuals. The consequence is sometimes hospital fever in its various degrees ; at others local complaints, as ulcers, ill-conditioned and spreading, cutaneous diseases, erysipelas, or ophthalmia ; all which have occurred, and been remarked by different army physicians, and even under certain circumstances in civil life. What has been said is, of course, only offered by conjecture ; but we conceive it ought to have been taken into the account.
The remainder of the paper is taken up with the mode of treatment, which, we doubt not, may be similar, whatever may be the primary cause, the effect depending, for the most part, on the condition and idiosyncrasy of the subject. The plan most successful was free and early evacuations. prehend how an author, professing to teach us accuracy in diagnosis, should give us the following history: " 3. Of inflammation of the large intestines:? On Friday evening, Mr. W. H. aged 50, and previously subject to dyspepsia, became seized with acute pain in the hypogastric region, attended with desire and difficulty of voiding urine. He seemed to experience relief by taking a little sp. ?th. nitros. The next morning his complaints were renewed, and they increased through the day. In the evening there was violent pain of the hypogastric region, inducing writhing of the body, and still attended with urgent desire to void urine, with ineffectual efforts. This Violent attack of pain seemed to have been immediately induced by the operation of a dose of oleum ricini. The pulse and tongue remained natural. Urine was voided, and ease obtained, on coming cut of the warm bath.
ic On the Sunday, the pain was felt extending generally over the abdomen. The desire to void urine continued, but the bladder was found empty on passing the catheter. No further alvine evacuation. Pulse nearly natural. " On Monday, there had been copious evacuations by stool, and some high-coloured urine had been passed. The pulse was 50, soft and regular; the tongue white. <c On Tuesday, the pain seemed to have been again induced by the scanty operation of a saline opening medicine. A particular pain was now distinctly referred to a spot in the left iliac region, increased by pressure, and attended with a more general pain of the abdomen. No writhing of the body, but a degree of restlessness, manifested by throwing about the hands and arms; much flatus on the stomach; a little vomiting, for the first time, on taking any thing; no continued nausea or retching. Pulse 96, in the evening 84, soft and regular; the pain of the abdomen continuing; tongue white and loaded.
About four A. M. on Wednesday, the 6th day of the disease, the hands were observed to be livid and cold, and the body to be covered with a profuse cold sweat. At seven A. M. the pulse was 124 and small. A fixed pain, similar to that formerly described as felt in the left iliac region, was now distinctly described, as affecting this region on the right side, the former pain having now nearly ceased. The patient was affected with a fallen countenance, a general coldness, and profuse perspiration, clamminess of the mouth, and change of voice. The pulse became gradually smaller and indistinct, and the patient expired at four P. M. " On examination of the abdomen, there appeared much exudation and tender adhesions over the surface of the bowels. The ileum, caecum, and colon, were injected with numerous blood-vessels ; in some parts so as to acquire a dark colour, but the texture remained entire and firm. The appendiculae pinguedinosas were Injected and covered with a viscid effusion, communicating the appearance of a mass of disease* The external and posterior portion of Edinburgh Medical and Surgical Journal. 419 ef the bladder appeared also a little injected ; its internal surface was perfectly natural. The stomach, duodenum, jejunum; the liver and spleen ; the heart and lungs, appeared natural and unin* flamed. " This case, which the author has endeavoured to describe with the utmost accuracy and succinctness, seems to have been a spas, modic affection, succeeded by inflammation of the large intestines, and perhaps, in a slight degree, of the bladder. Its principal features were the following: At first, violent pain in the hypogastric region and lower part of the abdomen, inducing writhing of the bo.iy, and atteuded with strangury and constant desire to void urine. The operation of medicine was effectual, but induced the most violent pain. No vomiting. Pulse natural. Afterwards, there was violent fixed pain, referred to a particular spot, tender under pressure, without writhing of the body, but with an appear, ance of restlessness. Less strangury. Tenesmus; the ready but painful operation of medicine on the bowels. Little or no vomiting. Pulse little affected until the appearance of cold sweat. A peculiar expression of countenance, induced by the action of the depres^ores {tnguiorum oris. u Dr. YViIian, in the Diseases of London, has some excellent observations 011 the diagnosis of the affection in question. He observes, that 4 mistakes arise respecting inflammation of the lower intestines, or of the colon about its connections with the cascum or rectum.
It does not, as in the case of inflammation of the ileum, or of any p irt of the smaller intestines, occasion, by excruciating pains, instant debility and depression, with vomiting, cold sweats, &c. There is at first a local but moderate pain, somewhat aggravated by pressure, and attended with thirst and general uneasiness. This pain seems afterwards to diffuse itself, producing strong contractions of the bowels and abdominal muscles, which recur from time to time, but have considerable intervals of ease and tranquillity. The disorder differs, however, from the colic, in this respect, that it is not attended with obstinate costiveness, and that after sufficient evacuations the pain is not mitigated. On the other hand, as the intestine is tender, and probably contracted about the seat of inflammation, a most severe pain is often excited by the operation of the mildest purgative. The pulse may at the beginning be hard and contracted, but it soon becomes weak, small, and perhaps irregular. There is a fur upon the tongue, somewhat thick, and of a whitish colour. The urine has a smooth pink sediment, which, as the disorder advances, changes its colour, and resembles a rough cretaceous powder. Vomiting is not a constant symptom in this form of enteritis." With these judicious remarks of Dr. Willan's before him, why should Dr. Hall speak of a spasmodic affection, succeeded by inflammation, &c. ? Was not the first symptom " acute pain with a desire and difficulty of making water?" Could diagnosis afford stronger proofs of acute inflammation in the 3 h 2 ' pelvi^ 420 Critical Analysis, pelvic viscera??We shall not dwell on this subject, bufe conclude with an expression of doubt whether typhus or spasm has been the most mischievous word in the language of medicine.
The beneficial effects of confinement and regulated temperature during the use of mercury in the cure of sj^philis, have been too long admitted to require any particular notice.
Art. V.?Case cf Re-union of a separated Portion of the Finger ; by Mr. James Braid, Surgeon at Leadhills. These and other cases which have lately occurred, show that on all occasions attempts should at least be made to reunite divided surfaces.
Art. VI.?A Case, disproving the Doctrine, that the Surfaces of a Wound in a State of Suppuration will not re unite by the first Intention. By William Balfoue, M.D. Edinburgh.
It is absolutely necessary that men should understand one another before they attempt to disprove. In the southern metropolis, union by the first intent is the inosculation of divided vessels; and that such really takes place, we have demonstrative proof, after the division of a vessel in the blood-shot eye, which, on the following day, we often find re-united. But, when suppuration has taken place, the action and configuration of parts is altered. In these cases, however, union may take place in two ways ; by coagulated lymph if the parts are clean and excited to inflammation, or h* granulations if they comein to contact, each on the sup-}jurat ing surface. The present case seems a compound of )oth, but certainly not a case of union by the first intention.
Art. VII.?Observations, with Cases, illustrative of a New, Snnple, and Expeditious Mode of curing Gout; by Wm. Balfour, M.D. Edinburgh. We shall give one of these cases without any remarks of the author or of our own. 421; tc When L first saw him, the balls of the toes were still much Swelled, pained, red, tense, and shining ; and motion of the joints impracticable, lhe whole upper part of the foot, particularly about the roots of the toes and outer ankles, was (Edematous.
The legs were generally swelled as high as the calf; and along the temio Achillis, especially at its commencement, very painful. Tha patient was very lame. He described himself as having had a pa, rox\sm every night from the commencement of the complaint,? as the pain and heat were, in the night time, intolerable. Had taken no medicine; pulse 80; no appetite. " I applied compression to the balls of the toes; friction to tha cedematous parts; pcrcussion to the ankles; and friction and percussion to the legs,?surrounding all the parts, afterwards, with a roller. The patient walked better immediately. Ordered a brisk purgative of decoction of senna and Epsom salts. <c 3d.

Medicine operated smartly.
Underwent the same treatment this morning as yesterday, with increased advantage. <4 4th.?All the symptoms declining; and walking greatly im? proved.